St. Mary Medical Center's Matthew John: Time for a FITT Prescription’?

Warmer temperatures and longer periods of sunlight have many of us yearning for outdoor opportunities to cast off the sedentary restrictions of winter. But often, our Olympic-standard desires to achieve “faster, higher, stronger” lead to “too much, too soon, too fast” – and injury.

Warmer temperatures and longer periods of sunlight have many of us yearning for outdoor opportunities to cast off the sedentary restrictions of winter. But often, our Olympic-standard desires to achieve “faster, higher, stronger” lead to “too much, too soon, too fast” – and injury.

Limitations come with age. Tightening and degradation in your muscles and joints actually begins in your 30s. The prevalence of osteoarthritis and other chronic illnesses increases as well. This only gets more pronounced in your 40s and beyond.

Cartoonist and author of Ask Aunt Violet, Caryn Leschen, puts it well, “Thirty-five is when you finally get your head together and your body starts falling apart.” Actually, the “head” part of this formula has a lot to do with the body when it comes to exercise.

The medical profession, aided by mass media and social networks, has done a pretty good job at selling the benefits of an active lifestyle. Few weeks go by that I don't see another study showing just how important activity is to one's health, whether you are six or 86.

Earlier this month, The British Journal of Sports Medicine analyzed 24 studies, finding short bouts of exercise boosted brain function and self-control in a number of young age groups. They suggest exercise might be a useful treatment for impaired higher brain functions, such as attention hyperactivity deficit disorder (ADHD) and autism, and may help delay the ravages of dementia.

Recently, The Journal of Pediatrics showed that children who were more physically fit tended to do better on math and reading tests than children who were less active and heavier. This news may be of interest to school districts considering further cutbacks in physical education programs in an effort to concentrate on core academics.

But, encouraging more activity can (and does) have unintended consequences. It's important to be prepared for the various types of injuries that can come with our exercise recommendations. This is why I got interested, and earned board certification in, sports medicine.

Those injuries coincide with age. Typically, older patients present with knee and ankle issues, while my younger patients typically present with hip, thigh and calf muscle related problems. Most injuries happen because the patient over-stressed body parts that were not in a condition to be stressed. This is where the “head” part comes in.

I like my patients to be realistic about their bodies and their expectations for exercise. I want to know their goals. Do they want to run a marathon or a 5K? Are they expecting to play competitive or recreation league team sports into their 40s and 50s? Or are they merely looking to live a healthier lifestyle?

For those over 30, my recommendation is to see a doctor before starting an exercise program, particularly if they have a sedentary lifestyle or chronic illness such as hypertension, diabetes, mellitus or cardiovascular disease. I might want them to undergo a stress test or other examination that provides risk stratification and condition information that may help in avoiding injury or exacerbation of their chronic illness.

Page 2 of 2 - I then want to develop a plan that is no different from what a doctor would do in diagnosing and treating an illness with medication. In fact, like a growing number of physicians, I actually prescribe it. I call it a FITT prescription, detailing the Frequency, Intensity, Type and Time (duration) of exercise.

With this, I can follow progress and make modifications. It is a targeted approach somewhat similar to functional training, which came out of rehabilitation treatment. Just as some therapists need to retrain patients with movement disorders, some of my patients need to work on strengthening joint muscles, or increasing their endurance.

Followed correctly, such plans can lead to better joint stability, increased strength and flexibility and less chance of injury. And, we know that exercise does a body good, lowering the risk of many chronic illnesses, including heart disease, Type 2 diabetes and depression.

Just remember to keep your head in the game.

Dr. Matthew W. John is in family practice and is certified in sports medicine with Oak Grove Medical Clinic. He can be reached at 816-690-6566.